Barretto Marcos Guilherme Praxedes, Costa Maria da Graça Nascimento Figueira, Serra Maria Cristina do Valle Freitas, Afiune Jorge Barros, Praxedes Hugo Eduardo Pinheiro, Pagani Eduardo
Hospital de Restauração, PE.
Rev Assoc Med Bras (1992). 2010 Jan-Feb;56(1):51-5. doi: 10.1590/s0104-42302010000100016.
This was a prospective, randomized, open-label study controlled by active comparator. The aim was to assess analgesic efficacy and overall tolerability of a burn treatment based on topic administration of unfractionated heparin.
Fifty eight male or female patients were randomized for conventional treatment (group C) or topical heparin treatment (group TH). Ages of patients enrolled ranged from 18 to 55 years. They had 2nd and 3rd degree burns on 10% to 30% of the body surface (BS) caused by fire or scald, no hemorrhagic diseases, no hypersensitivity to heparin and less than 10% of the BS burned to 3rd degree. The group C had frequent debridement under anesthesia or analgesia and received silver sulfadiazine dressings. The group TH had the first debridement and their wounds left open to receive 4200 IU of unfractionated heparin topically for each 1% of burned BS, three times daily. Efficacy was evaluated from files of the 38 patients who completed the study according to demand of analgesic medications and response to the pain Visual Analog Scale (VAS). Tolerability was evaluated from the files of all 58 randomized patients by the comparative incidence of adverse reactions.
The group TH demanded less analgesic medications (11.83 +/- 9.38 per patient against 33.35 +/- 20.63 for the C group, p<0.01), reported less pain in the VAS, had less fever and more bleeding than group C. There was no difference in the incidence of local infection, septicemia and safety exams.
The group TH presented less pain without important tolerability problems.
这是一项由活性对照剂控制的前瞻性、随机、开放标签研究。目的是评估基于未分级肝素局部给药的烧伤治疗的镇痛效果和总体耐受性。
58名男性或女性患者被随机分为接受常规治疗组（C组）或局部肝素治疗组（TH组）。纳入患者的年龄在18至55岁之间。他们因火灾或烫伤导致身体表面积（BS）的10%至30%出现二度和三度烧伤，无出血性疾病，对肝素无过敏反应，且三度烧伤面积小于BS的10%。C组在麻醉或镇痛下频繁进行清创，并接受磺胺嘧啶银敷料。TH组进行首次清创，伤口敞开，每1%烧伤的BS局部给予4200国际单位未分级肝素，每日三次。根据镇痛药物需求和疼痛视觉模拟量表（VAS）反应，从完成研究的38名患者的病历中评估疗效。通过不良反应的比较发生率，从所有58名随机分组患者的病历中评估耐受性。
TH组所需的镇痛药物较少（每位患者11.83±9.38，而C组为33.35±20.63，p<0.01），VAS报告的疼痛较少，发热较少，但出血比C组多。局部感染、败血症和安全检查的发生率没有差异。
TH组疼痛较轻，且无重要的耐受性问题。
